Goldberg H B, Schmitz R J
Abt Associates, Inc., Cambridge, MA 02138.
Health Care Financ Rev. 1994 Fall;16(1):109-30.
Implementing a per-episode prospective payment system (PPS) for home health services is one option for Medicare policy makers facing rapid increases in service use and expenditures. Analysis of data on recent episodes of Medicare home health care identified systematic differences in service patterns across provider types; these indicate potential differences in the capacity of agencies of different types to adjust to PPS. The second phase of a national demonstration, which is about to be implemented, will provide information on the extent to which the agency practices that generate much of the observed variation (such as the number of visits provided per episode) are susceptible to management decisions; and whether managers can and do respond to the incentives of per-episode prospective payment.
对于面临服务使用量和支出迅速增长的医疗保险政策制定者而言，为家庭健康服务实施按每次事件的前瞻性支付系统（PPS）是一种选择。对医疗保险家庭健康护理近期事件数据的分析发现，不同类型提供者的服务模式存在系统性差异；这些差异表明不同类型机构适应PPS的能力可能存在差异。即将实施的全国示范项目的第二阶段将提供信息，说明产生大部分观察到的差异的机构做法（如每次事件提供的访视次数）在多大程度上易受管理决策影响；以及管理者是否能够并确实对按每次事件的前瞻性支付激励做出反应。
